| Objectives: Fractures of the distal femur are rare and severe,which are often caused by high energy trauma.Distal femur fractures are uncommon,but an important cause of patient morbidity.Patient disability will not only cause potential life loss,but also bring huge economic losses and the corresponding social burden.With the rapid development of social economy,followed by the occurrence of traffic accidents,industrial and agricultural accidents,accidental damage to the elderly and natural disasters,the number of patients with distal femoral fractures will also be greatly increased.The epidemiological study can indicate the existing distribution and development trend of distal femoral fractures.There are more studies on the epidemiological study of distal femoral fractures in a single area,but multicenter comparative studies are rare.This study retrospectively investigated the imaging data of distal femoral fractures in 63 hospitals in eastern and western China from 2010 to 2011 to analyze epidemiological characteristics and changes of these fractures by large data.This study will complement epidemiological data and provide a reference for preventing the occurrence and clinical diagnosis and treatment of these fracturesMethods: Cluster sampling method was used to choose 35 hospitals in eastern China and 28 hospitals in western China.The data of adult patients with distal femur fractures treated from January 2010 to December 2011 in 63 hospitals were collected through the PACS system and case reports checking system.Exclusion criteria: referral case,old fracture,pathological fracture and periprosthetic fracture.We try our best to collect the whole information of each case to ensure the integrity of our data.Relevant reviewers were strictly trained to classify the fractures according to AO classification.Two orthopedic chief physicians and one radiology chief physician are responsible for quality supervision.The data from 35 hospitals in East China were classified as group A and those from 28 hospitals in West China were as assigned into group B.The age of the patients was divided into 8 age groups according to the age of 10 years.The data were analyzed by IBM SPSS 21.0 package.The significant difference was defined by P<0.05Results: A total of 2523 adult distal femur fractures were collected with a male to female ratio of 1.58:1,accounting for 8.95% of adult femoral fractures and 0.92% of all adult fractures.The median age was 47 years old with the quartile range of 34 to 60 years old.There was no significant difference in the ratio of male to female and median age between the two groups.The number of fractures showed a bimodal pattern in relation to gender and age,tending to occur in young males and in elderly female.The age of high incidence fracture was concentrated,which was 31 to 60 years of age group.According to AO classification,the proportion of type 33-A was the most and type 33-B was the minimum in both groups.The proportion of type 33-B of group A was significant higher than that of group B while type 33-A of group A was significant lower.The subtype of high incidence fracture was type 33-A1 in both groups,but the composition of group B(37.69%)was significant higher than that of group A(25.39%).Conclusion: Fractures of adult distal femur accounted for 8.95% of adult femur fractures,accounting for 0.92% of all adult fractures.The peak age ranges were from 31 to 60 years old in East and West of China.These had a bimodal age distribution trending to occour in young male patient and in elderly female patient.The more common fracture was type 33-A and subtype 33-A1 in both areas.Compared with West areas,East areas had a significant higher proportion of fracture subtype 33-B1 and subtype 33-A3. |
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